Pennine Integrated Care Partnership Profile

This profile provides an overview of the ICP, including demographics, deprivation and key indicators which have an impact on health. Some of these have been highlighted as ‘positives’ or ‘challenges’ for the ICP. These may be areas that need promoting, protecting or improving. Unless stated, the statistical significance comparisons are with . Please note, while the overall value for the ICP may be significantly different to England, the individual districts which make up the ICP may show variation (noted below). All proportions, rates and values can be found on the spine chart on page four, along with the full suite of indicators for the area. We also have calculated the variation which exists in the ICP, with the last two columns showing the lowest and highest values in the area.

Key findings

A good start in life is vital: the experiences a child has in their early years can have an impact on their future health and wellbeing. Some children may experience educational, social and health disadvantages that follow them through life. These may include factors such as being born to a teenage mother and/or being a low birth weight. Missing school through hospital stays, or having excess weight can also affect a child’s development. Protective factors, which promote wellbeing and mitigate risk, such as being school ready, and performing well at school, can lead to opportunities to thrive in life.

Positives for the ICP  A&E attendances in under-fives is significantly better than England for all three districts ( and Pendle are significantly higher).  Significantly more children are ‘school ready’ at age five in and Rossendale ( with Darwen, Burnley and Pendle are significantly lower).  GCSE achievement is significantly better in Ribble Valley ( and Rossendale are similar).

Challenges for the ICP  One of the main areas is admissions for injuries, with the ICP significantly worse for children under- five and children under-15 years.  Admissions for injuries in young people (15-24 years) is significantly higher (Ribble Valley is similar).  The emergency admissions rate for children under-five is significantly higher.  There are significantly more low birth weight babies (Ribble Valley and Rossendale are similar) and significantly more deliveries to teenage mothers (Blackburn with Darwen, Pendle and Ribble Valley are similar.

National IMD 2019 quintile distribution of Deprivation and poverty can be the biggest risk registered patients by ICP (compared with ICS) factors for poor health and wellbeing. People living in deprived areas are more likely to have poorer health outcomes and a reduced life expectancy. They may also have inequalities in life chances and fewer opportunities, compared to their counterparts in less deprived areas. There is a stark contrast in deprivation, with some of the most deprived and least deprived in the ICP and England.

Population breakdown based on Sept-19 GP registered population Pennine Lancashire Integrated Care Partnership Profile

Moving through life, where a person lives, their lifestyle, their social connections and their economic position continue to have an impact on physical and mental health and wellbeing. Having these as positive influences increases the likelihood of having a healthier life (including a healthier and longer life expectancy). Conversely, a lack of these can lead to an higher risk of poorer health and wellbeing, which can be seen through higher levels of hospital admissions, illness and mortality. Pennine Lancashire ICP has some significant challenges, with many of the indicators showing as significantly worse than England. Partners (including communities) working together in these areas can have an impact on the health and wellbeing of their residents. Positives for the ICP  Incidence of prostate cancer is significantly lower (Ribble Valley and Rossendale are similar).*  Incidence of breast cancer is significantly lower (Burnley, , Pendle and Ribble Val- ley are similar).  Incidence of colorectal cancer is significantly lower (Blackburn with Darwen, Burnley, Hyndburn, Ribble Valley and Rossendale are similar). *lower incidence of disease may be due to effective screening and/or healthier lifestyles, but equally it may be due to a gap in screening and diagnosis. Looking at this in respect of the local population is important.

Challenges for the ICP  The proportion of people with a long-term illness or disability is significantly higher (Ribble Valley is significantly lower).  Emergency hospital admissions for coronary heart disease is significantly higher (Ribble Valley is similar).  Emergency hospital admissions for myocardial infarction is significantly higher (Ribble Valley is similar).  Mortality from coronary heart disease is significantly higher.  Mortality from circulatory disease (for all ages and under-75) is significantly higher (Ribble Valley is similar).

Additional district-specific public health areas of work based on indicators below show smoking at the time of delivery is significantly worse across all districts. The rate of people killed and seriously injured is significantly higher across several of the districts (rurality may be a factor).

Source: PHE, Fingertips * Aggregated from all known lower geography values, $ data quality issues, - No data

Significantly worse than England Significantly better than England Similar to England Pennine Lancashire Integrated Care Partnership Profile Population

The registered population is 564,937 - 50.4% are male Age Male Female 49.6% are female 00 - 04 17,116 16,481

05 - 09 19,135 18,264

10 - 14 19,086 18,216

15 - 19 17,297 16,176

20 - 24 16,597 15,719

25 - 29 18,720 18,487

30 - 34 19,919 19,653

35 - 39 19,443 18,894

40 - 44 17,647 16,445

45 - 49 19,432 18,286

50 - 54 20,349 18,952

55 - 59 18,760 17,988

60 - 64 15,817 15,646

65 - 69 13,929 13,646 Compared to England there are: 70-74 13,345 13,705  more children and younger people aged up to 19 years (males and females) 75-79 8,503 9,356  fewer younger adults (20-34 years) 80-84 5,517 6,960

 similar proportions of people aged 40 to 59 years (males and 85+ 4,143 7,308 females) Total 284,755 280,182  fewer people in the older age brackets (80+)

Ethnicity

Ethnicity breakdown % by ICP, compared with ICS and England* Key findings:

 There are fewer white residents compared to the ICS and England.

 The ICP has the highest proportion of residents who are Asian, both in the ICS overall and compared to England.

 There are fewer black residents compared to England.

*Census 2011 Pennine Lancashire Integrated Care Partnership Profile

Significantly worse than England Significantly better than England Similar to England

*ICP value based on aggregated LA values Pennine Lancashire Integrated Care Partnership Profile Gaps in life expectancy

Many factors can contribute to the gap in life expectancy. Further analysis can help to identify where these gaps are and provide direction on action to reduce them. The table below shows life expectancy overall and the gap in life expectancy between the local authorities in the ICP and England and within the ICP districts (for deprivation) (2015-17). Life Life Absolute gap in life Absolute gap in expectancy in expectancy in expectancy Life Life life expectancy most deprived least deprived between local expectancy expectancy between most and quintile of quintile of authority and (years)-local (years)- least deprived local authority local authority Local authority England (years) authority England quintile (years) (years) (years) Males Blackburn with Darwen -2.9 74.2 79.6 -9.1 73.1 82.2 Burnley -3.4 78.2 79.6 -8.3 72.3 80.6 Hyndburn -2.5 78.7 79.6 -10.2 72.3 82.5 Pendle -1.4 78.5 79.6 -8.3 74.4 82.7 Ribble Valley 1.9 77.8 79.6 0.7 82.7 82.1 Rossendale -0.9 81.5 79.6 -5.6 75.3 80.9 Females Blackburn with Darwen -3 79.6 83.1 -6.8 78.5 85.3 Burnley -2.3 81.5 83.1 -6.8 78.1 84.9 Hyndburn -2.1 82.6 83.1 -10.4 75.9 86.3 Pendle -1.8 82.4 83.1 -6.6 78.6 85.2 Ribble Valley 0.5 81.1 83.1 -2.2 83.6 85.8 Rossendale -0.9 83.6 83.1 -3.2 81.2 84.4

The chart below shows for males, for each broad cause of death, the contribution that it makes to the overall life expectancy gap between the most and least deprived areas in each local authority across the ICP (2015-17). The analysis of detailed causes of death can be used to give an indica- tion of the drivers of inequality in the area. Positive-higher mortality in the most deprived quintile is contributing to the gap and negative-lower mortality in the most deprived quintile is offsetting the Pennine Lancashire Integrated Care Partnership Profile Gaps in life expectancy

The chart below shows for females, for each broad cause of death, the contribution that it makes to the overall life expectancy gap between the most and least deprived areas in each local authority across the ICP (2015-17). The analysis of detailed causes of death can be used to give an indica- tion of the drivers of inequality in the area.

Top six causes contributing to the gap in life expectancy

When looking at the Males Females charts (above) in more detail, the table (right) 1 Heart disease Heart disease shows the top six causes Chronic lower respiratory Chronic lower respiratory 2 diseases diseases of death contributing to the gap in life expectancy 3 Cirrhosis and liver disease Other between the most and 4 Lung cancer Lung cancer least deprived areas in the ICP for males and 5 Other Other cancer females. 6 Accidental poisoning Flu and pneumonia Index and data sources